HomeMy WebLinkAboutPermit Building 1992-8-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olfice: 726.3759
..
SPRINGFIELD
LOCATION OF PIlOPOSED wonK: _. '73 5,'v
ASSESSORS MAP: _1.2/J?" 2-7
J:cWZ! 6~A_L
2-4 .
LOT:
BLOCK'
c() UA"-1...--
SCAIl ~L' ~_G~.e.~V\V'I
OWNER: ~~
ADDRESS: ~~::X~
CITY: IS, ~
DESCRIBE WORK: _A/ ~)
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NEW
REMODEL
ADDITION
(:)viv'Z.
STATE:
OR
-
Cl2/{)R> 8
,;
4(~(
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
, "!
TAX LOT'
2Qcro
SUBDIVISION'
PHONE: -=:l1I-1a 1..9 L.
ZIP:~
DEMOLISH
OTHER
Mi ~rA'~~
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE: __._._____
l,tEAT SOURCE:
RANGE"
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
~ Rough Electrical - Prior to
...over.
D Electrical Service - Must be
approved 10 obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~rnmln{) - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior 10 taping.
D Wood Stove - After Installatlon.
D Insert - After fireplace approval
and InstallatIon of unit.
o
Curbcul & Approach - After
1m illS arc oroetoel but prlol to
placement 01 concrete.
Ju~
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR ·
GENERAL --E-'~--lk4;;IiIL&tI. -- -;T.~ ~/5 S-
" 2t3?'/6 &/?I-<-<?'S miG ~/
I LUMBtNG: --' - --.-----
MECHANICAl'
ELECTRICAl'
QUAD AREA: _.. _
. OF BLDGS: __ _
OCCY CRour':_
. OF STORIES:
WATER HEATER:
EXPIRES
Y /15',3
PHONE
?f''f .-I'Jtj?
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS: _
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. Tills Is a 24 hour recordIng. Alllnspoctlons requested before 7:00 a.m. will be
maclc the same working clay. inspections requesled after 7:00 a.m. will be made the following work day.
o Temporary Electric
D
Sito Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab PlumbingfEfeclrical1
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
D
Mnsonry - Stool location, bond
beams, grouting.
D Foundation - After forms are
creetcu but prior to concrete
placement.
D
Underground Plumbing - _Prior
to filling trench.
D
Underlloor Plumblngl Mechanical
_ Prior to Insulation or decklnn.
D
Post and Beam - PrIor to floor
Insulation or decking.
D Floor Insulation - Prior to
deckina.
D Snnitary Sewer - Prior to filling
trench.
D Storm Scwer - Prior to filling
trench.
D Watcr Line - Prior to filling
trench,
D Rough Plumbing - Prior to
cover.
D Sidewalk & Driveway - Alter
oxcavation Is complete, forms
and sub.base material In place.
D Fence - When completed,
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing work Is complet.e,
~ Final Eleclrlcal - When all
~electrlcal work Is complete.
D Final Mochanfcal - When all
mechanical work Is complete.
r\:7r Final Building - When all
~equlred Inspections have been
approved and building is
completed.
DOlher
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sower,
D Electrical Connection - When
blocl<lng. set.up, and plumbing
Inspections hove been approved
and the home Is connected to
the service panel.
D Final - Alter all roqulred
Inspections are approved and
porches, sklrtln'g, decks, and
venting have been installed.
Lot faces
Lol Type"
Interior
Setbacks
.--r--I--'~
P.L. HSE GAR ACC
Lot coverage
Corner
N
~HE PROPOSED WORI< IN THE
~TORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application rnu5t be signed
and approved by the Historical
Coordinator prior to permit issuance.
Lot sq. fig.
Topography
Totai height
Panhandle
2....- _ ---
.:!'!- - ---
Cul.de.sac
~E
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $fSO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Carport
This permit is granted on the express condition thaI the said
construction shall, in all respects, conform to tllO Ordinance
adopted by tile City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any proVisions of said ordinances.
Main
Garage
Building Permit Fee
J .5"tJ Os)
/560
.75"
/5.?s:'
SYSTEMS DEVELOPMENT CHARGE (SDC)
~/A-
Plan Check Fcc: ___
Date Paid: .
Total Value
Receipt Number:
/hl/VI
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Dale
(B)
Systems Development Charge i~ due on all undeveloped
propertles wllhin tile City limits which arc beinu improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing PermIt
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I slate and agree, that I have cmefully examined
the complcled application and do hereby cerlily thaI all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
wilh the Ordinances of the City of Springfield, and the Laws
of the Slate of Oregon pertaining to the worl~ described
herein, and that NO OCCUPANCY will 'be made of any
struclure without permission of the Building Safety Division.
I further certify ttlat only contractors and employees who
arc in compliance Witll ORS 701,055 will be used on this
projecl.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure Ihat all required inspections arc
requested althe proper time, thaI each ad<.llcGG is readable
from the slreet, that tllO permit card is located at the front
of the property, and tile npprovcd set of plans will remain
on the Si~e . all limes durln(l COn:lruCllon.
Slgnalllrc _ J... / G/J ~
Dale4- O-~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
VAll DATION:
RECEiVED BY
5'~JeI
95 -//J/??
~7./
L '
~ -*-z...,
RECEIPT NUMBEfl
Total Miscellaneous Permits (E)
DATE PAID
TOTAL AMOUNT DUE (excluding electrlcai)
(A, B, C, 0, and E Combined)
/'F;7S'
AMOUNT nECEIVED